The Creative Embodied Experience: The role of the body and the arts in infant mental health

“The body has to instruct the brain.”

“Behavior does not live in disembodied form.”

Thelen (1996, p. 31)

In recent years the interest in the role of the body and embodied experience as it informs selfhood and forms of attachment has increasingly gained more attention. Many theories of psychological inquiry have addressed the body and the psyche: Freud, Reich, Winnicott, Darwin, Bowlby, Trevarthen, Stern, Boston Change Study Group. The advent of the mirror neuron system has brought the neurological underpinnings of this into sharper focus.

As defined by Gallese and his colleagues (Gallese, Fadiga, Fogassi, & Rizzolatti, 1996; Gallese, 2005; Gallese, Eagle & Migone, 2007), through neural mapping in the brain multisensory sensations, actions intentions and emotions of others are experienced and understood by the dyadic partner. Through this experience a “shared body state” is experienced supporting the development of intersubjectivity (Gallese, 2009, p.523). Malloch and Trevarthen add a creative focus to this discuss emphasizing the role of creativity in this process using the term “musicality” to described the shared consciousness that develops in the emerging mother- infant relationship through moment-to- moment loving joyful rhythmic nonverbal movement and vocal exchanges (Malloch & Trevarthen, 2009, p.1; Trevarthen, 1980, p. 319; 2009, p. 508).

This emphasis on the creative process from an embodied state of knowingness and communication is a core component in the field of dance movement psychotherapy (DMT). Given the prevalent nonverbal nature of infancy and early childhood experience DMT methodology is an important addition to the field of infant mental health, providing activities along the spectrum of wellness to therapeutic treatment.

Specific movement, multisensory, creatively-based dyadic and group activities, which enhance the young child’s growing sense of self, physically, emotionally, expressively, and cognitively are a core emphasis of the DMT-based program I have developed called Ways of Seeing (Tortora, 2004, 2006, 2010 a, 2010b, 2011). These activities are designed to support the parent-child attachment relationship and are used in preventative and intervention programs. Tools to teach parents how to read and understand their child’s nonverbal cues while providing playful ways to improve the parent- child relationship are central elements of this program. Assessment and intervention components are also included in Ways of Seeing to support young children and families with a variety of difficulties including trauma, post partum depression, developmental and sensory processing disorders, medical illness, attention deficit and hyperactivity and Autism Spectrum Disorders.

Ways of Seeing utilizes nonverbal movement observation, dance, movement, motor development and body awareness activities, music, and play for the assessment, intervention and educational programming of children and their families. These programs are based on the observational analysis principles of Laban Movement Analysis (LMA) (Bartenieff & Lewis, 1980; Laban, 1975, 1976; Laban & Lawrence, 1974; Stern, 2010); infancy and early childhood developmental theory; and dance movement therapy practice.

Introduction to the Ways of Seeing program

As I shared during my presentation in Leipzig (June 2010) the focus of this work, with babies, toddlers, children and parents is to understand the role of movement, multisensory experience, and the nonverbal exchange in the expression of self, self and other, and the developing attachment relationship. Ways of Seeing is relationship-based. The word seeing in the title is used to emphasize that there are many ways to look, to assess, and to receive information about self and other (Tortora, 2006). In this program the practitioner learns how to observe and understand the communicative elements of each person’s nonverbal personal movement style.

A key concept of this work is the understanding that qualitative aspects of an individual’s movement style reveal information about one’s emotional, social, physical, communicative and cognitive development. The nonverbal observational tool called, Dyadic Attachment-based Nonverbal Communication Expressions (D.A.N.C.E) (Tortora, 2010a, 2010b, 2011) enables the practitioner to observe the nonverbal qualitative components of each person’s style in the context of the dyad. This tool provides specific information regarding the nonverbal dynamics that support or compromise self-regulatory and coregulatory aspects of the relationship. Specific questions are provided to guide the infant specialist or psychotherapist to observe how the baby cycles through states of engagement and disengagement and how the adult caregiver supports or misses the baby’s nonverbal cues. Contingent and non-contingent behaviors are delineated and can be approached by bringing the nonverbal elements that drive these behaviors into conscious awareness.

This tool highlights the embodied experience for both the caregiver and the baby. The nonverbal aspects of behavior can be quite overt or subtle. The key here is to consider how the nonverbal qualities that comprise these behaviors affect the developing relationship. The following [composite] case vignette of a typical way Ellie approaches her 6-month old baby Aaron elucidates these points.

Ellie and I are sitting on the floor talking. Aaron is lying on his back on a blanket on the floor about three feet away from Ellie. Aaron begins to become fussy, kicking his legs in a random stop and start rhythm as he shifts his head and looks directly toward Ellie. Ellie looks over at Aaron for a moment, her facial muscles tense. She pauses, stops speaking and holds her whole body still for about three seconds. The strength and speed of Aaron’s kicking increases as Ellie looks toward him. Ellie responds by increasing the tension in her whole body. Her eyes have a direct stare as she adverts her gaze to the left, away from Aaron. Her facial muscles heighten in intensity as her jaw tightens. Suddenly she abruptly moves sliding in her seated position toward Aaron and then abruptly stops when she is very close to Aaron, pausing for another approximately three seconds. She holds her body tall and rigid not arching over to bring her face closer to Aaron. She adverts her gaze from Aaron as she states, “What do you want?” The quality of her voice amplifies this tension and Aaron responds by accelerating and increasing the tone of his vocalizations. She bends over and picks him up. She places him in her lap facing away from her. Aaron’s torso is concave against the front of her body and his head is hanging forward as he continues his accelerated cry. He again creates a stop and start phrasing quality to his actions as he tries to turn his whole body to face Ellie. Ellie continues to hold her body tall, not embracing Aaron by shaping her torso around him. She redirects his twisting actions by increasing the tension in her hands to hold him more firmly facing forward. She and Aaron are both in a heightened agitated state. Aaron becomes very difficult to sooth at this point, squinting his eyes tightly as he kicks and arches his body backward. Ellie states, “See he doesn’t like me.”

During treatment these observations are addressed with Ellie in several ways. Jointly watching a videotape of this interaction opens a discussion with Ellie regarding her immediate feelings in response to watching the video, as well as the underlying meaning and feelings she had during the interaction. Together we look at the more overt and subtle nonverbal dynamics of their interaction. As will be exemplified later in this paper, we explore these qualities both through our conversation, specific body awareness, movement, and dance activities with Ellie and through interactive dance activities with Aaron. The term dance is used here both metaphorically and quite literally. Through discussion and exploration Ellie learns about her own nonverbal expressions. With this knowledge she explores playful ways to interact with Aaron expanding the qualitative range of her action repertoire. Together she and I observe Aaron’s nonverbal responds. This enhances Ellie’s ability to attune to Aaron’s more subtle cues. Music that compliments or matches the style of the spatial approach and contact is used to explore playful ways to approach and engage with Aaron. Spontaneous improvisational dances between Ellie and Aaron develop. These dances become part of their playful repertoire, expanding their relational rapport. New ways to engage evolve.

Sense of Body (Tortora, 2006)

  • An infant’s earliest experiences occur through the body.
  • They are initially registered on a somatic, kinesthetic, sensorial level.
  • These body-oriented experiences shape:

– How the infant begins to make sense of the world.

– How the infant begins to develop a sense of self as a feeling, acting, moving, communicating, cognizant being in the world.

– This body sensing includes sensing one’s own body as well as the body of another.

– Through this body sensing an infant first begins the dance of relating.

– The body and the (interactional) dance are continually intertwined, informing and developing one another.

This sense of body principle underlies how the baby processes his surroundings and develops relationships. It informs all of the practitioner’s observations of the child and the adult- child interaction, and influences how the wellness and intervention programs are developed.

Role of the body and the nonverbal multisensory experience in building relationships (Tortora, 2006)

We know that the earliest learning occurs in the context of interpersonal relationships. Babies discover themselves and understand their world as their caregivers and the environment respond to their self-directed actions. The Ways of Seeing approach places emphasis on attending to the specific qualities of the primary caregiver’s responses. This nonverbal aspect directly influences the baby’s developing curious nature. The nonverbal quality of the caregiver’s touch and holding style are especially noted as they may influence the baby’s experiences.

In this method the nonverbal element is accentuated in all areas of the baby’s development. Playful spontaneous movement-based interactions involving a mutual give and take between baby and significant adult support the development of a healthy bond. Communication, skills in relating, emotional, cognitive and motor development are effected by the young child’s movement and multisensory-based experiences with her surroundings. Simply stated:

  • Babies first learn through movementbased natural experiences.
  • Babies need to explore their bodies moving and they need to feel their bodies being moved to support their development.
  • Babies use their bodies and body actions to explore, communicate, and learn in their environment.
  • Babies don’t need “instruction” to learn. They need the freedom to explore safely, through active playful engagements with people and things.
  • Optimal learning requires the freedom of self-exploration through active physical engagement with people and objects.
  • Early experiences form memories that are registered and organized through somatic, sensory, kinesthetic and nonverbal modalities creating perceptual images. (Gaensbauer, 2004)
  • Babies translate their early perceptions and sensory-based experiences into actions.

The example of Aaron and Ellie above can be used to portray how this perspective influences my thoughts and approach to their treatment. As I observed their salient interactional style I am immediately drawn to the sequence starting with Ellie pausing and disengaging before she continues her contact with Aaron. What may Aaron be experiencing during the moments Ellie delays her contact? What does his heightened kicking during this time say about his experience and how may it influence Ellie’s subsequent response? How may the heightened tension in Ellie’s body when she lifts him, coupled with her adverted gaze be influencing the overall quality of their engagement? Keeping in mind the co-regulatory nature of repetitive dyadic interactions, how may this dynamic sequence of actions be affecting Aaron’s presymbolic representations of self and other (Beebe & Lachmann, 2002)? Ultimately if this becomes their predictable interactional style how will it affect Aaron’s growing sense of self-efficacy? Playfully trying on other ways to approach and contact Aaron through discussion, dance and music is a creative way to explore these questions. It provides a window into how flexible they can be with each other while creating opportunities for change and repair.

Understanding the role our own nonverbal personal movement style plays in interactions with infant and infant –parent interactions

In order to understand how nonverbal and multisensory experiences influence relationships it is also imperative to understand how the qualities of your own nonverbal experiences influence your interactions. In Ways of Seeing the practitioner monitors her/his own experience to be aware of how it may be influencing the therapeutic interventions with the child and other family members. This self-monitoring is similar to the psychological concept of countertransference. In Ways of Seeing the self-observation process has three components that enable the practitioner to analyze her/his experiential reactions in detail. Briefly outlined below these components involve both an objective description of each individual as well as the dyadic interactions, while paying close attention to your own reactions (Tortora, 2006, 2011).

  • Witnessing – Two parts: (a) objective mapping of actions; (b) self-reflective comments, describing your immediate general thoughts, personal reactions, and sensations, which may come up when engaged with or observing the child/parent/parent- child dyad.
  • Kinesthetic seeing – describes your sensorial experience. For example, did you hold your breath, change your breath rhythm, or increase your muscular tension level? Becoming aware of bodily reactions provides information about how the practitioner is experiencing the individual/dyad, and possible ways the individual/dyad may be experiencing the situation. This knowledge informs subsequent interventions and interactions.
  • Kinesthetic empathy – describes your emotional reaction derived from experiencing, observing and “trying on” the movements of the participants. Through awareness of your own emotional/bodily reactions you reflect on how the individual/dyad may be emotionally experiencing the situation.

Learning about and understanding your personal multisensory style, greatly supports the ability to observe, relate and be empathic. Insight about the role multisensory experience plays in the lives of families you are working with is heightened. The initial vignette above provides an example of the witnessing part (a) objective mapping of actions. The description enables the reader to clearly visualize the nonverbal components of the interaction. Evaluative commentary does not color the observation. The questions I pose that follow the description reflect witnessing part (b)- these are the immediate thoughts and personal reactions I have as I observe the dyad. This questioning directly influences how I approach Ellie and Aaron, and how I develop the movement explorations and choose the music.

As I approach Ellie I am aware of her tendency to suddenly disengage. As I observe this behavior with her son, I feel a jolt inside of me and I inadvertently hold my breath. This is my personal kinesthetic seeing response. Keeping this in mind, I momentarily check my own breath pattern making sure it is soft and flowing before I speak. I am conscious to keep my voice calm and clear, and my eye gaze directly toward her but gentle. Keeping in mind how she momentarily froze when Aaron’s behaviors toward her increased, I want to make sure my engagement with her is unimposing. The general posture of my body exudes a sense of flexibility. I keep my gestures small, light and fluid, and am careful to not hold any part of my body rigid.

As I watched her nonverbal exchange while simultaneously attuning to my emotional responses feelings of defensiveness and being overwhelmed with demands from others arise. This is my kinesthetic empathic response. This amplifies my awareness that the content of our work together has the potential to make her feel defensive. Is this how she is feeling and if so what are the specific verbal and nonverbal behaviors that trigger this response in her? I make a mental note to pay attention to the relationship between the verbal and nonverbal elements of the dialogue that precedes her momentary frozen postures.

Components of nonverbal observation

Utilizing nonverbal observation as a key to understanding an individual’s personal expression and interpersonal interactions involves looking at not only what the mover is doing but how the mover is executing the actions. It is the quality of the specific action the will reveal the meaning behind the behavior. The qualitative elements refer to the specific descriptive components of physical actions.

These qualitative elements derived from the Laban Movement Analysis (LMA) system (Bartenieff & Lewis, 1980; Laban, 1975, 1976; Laban & Lawrence,1974; Tortora, 2004, 2006, 2010a, 2010b, 2011) provide information about:

  • How (Effort) an action is performed from the perspective of time, flow, weight and attitudes toward space;
  • What (Body) body parts execute the action and how areas of the body move as a whole unit or individually;
  • Where (Space) it occurs in reference to others and the surrounding spatial environment.

These qualities are exemplified in the vignette. The specific LMA elements of Ellie’s nonverbal style are italicized here. Her Effort qualities include abrupt actions that suddenly stop. She holds her body with increasing bound tension, accentuated in the quality of her face, jaw, words and hands as she holds Aaron. These descriptions highlight the Effort qualities of time and flow. Her body attitude is noted specifically in the heightened tension of her face, jaw and hands and the tall stance of her torso. This description emphasizes where in her body the tension is expressed. The space category is noted when she slides on the floor directly toward Aaron, stopping when she gets close to him. She maintains an erect body position that does not soften or shape around him as she picks him up and holds him against her body. This description enables the reader to visualize her movement through space as she approaches and then physically engages her son.

Stern has brought attention specifically to the four elements of Laban’s Effort category – flow, time, weight, space – referring to them as the dynamic “four daughters of movement” that create the experience of vitality (2009, 2010, p. 4). As discussed by Laban, these Effort details provide the feeling tone to actions coloring an individual’s experiences and impact nonverbal expressions. Effort, body and space dynamics construct a nonverbal language of movement. Observation and analysis of this qualitative non-verbal language provides a window into a fuller understanding of an individual’s personal expressions and interactional style.

Derived from LMA, the key points of the Ways of Seeing observation process state:

  • Movement is expressive of self

– Each individual creates his or her own movement repertoire, movement signature, & movement metaphor:

– Movement repertoire – the range of movement qualities and elements that a mover uses to express him/herself.

– Movement signature – the specific qualitative actions used most frequently in the mover’s repertoire that most characterize or define the individual’s style of moving.

– Movement metaphor – specific, personally stylized nonverbal segments or sequences of movement that recur consistently within the mover’s movement repertoire and have symbolic meaning. Developed from a specific experience or set of experiences, this movement becomes distilled into an idiosyncratic gesture or group of actions.

The qualities of a mover’s movement repertoire connect physical action to emotional and social experience. The movement signature provides a link between the mover’s actions the mover’s perceptions and understandings of his/ her surroundings. A movement metaphor often becomes the core nonverbal expression depicting a significant psychic theme on an embodied level.

D.A.N.C.E. parent – child interaction questions

All interactions involve a nonverbal exchange between the participants. The Ways of Seeing program has developed a five-question protocol in D.A.N.C.E. to observe the quality of the parent-child interaction, based on the qualitative nonverbal elements discussed above in tandem with infant mental health principles. These components look at how the movers navigate their actions through the following elements: use of space, body, shaping of body actions, Efforts and phrasing of the movement actions (for brevity the definitions of these words are not explained here but can be found in my other published material, Tortora, 2006, p. 217). It is important to note that D.A.N.C.E. was designed to look at the parent-child dyad because that is the most typical clinical situation in which it is used. However, it can easily be adapted to observe multiple people simultaneously engaged [with the baby].

  1. How do the movements of the adult establish a holding environment supporting the waxing and waning of attention?
  2. How are turn-taking interactions opened and closed through each participant’s movements, specifically looking at how they initiate, withdraw and resume contact?
  3. How do mirroring, attuning and mismatch and repair cycles occur through body movement dialogue?
  4. Does the adult attune to the child’s style as reflected in the child’s cues, giving room for the child’s expression before intervening, or does she respond without attending to the child’s style first? How is this expressed through the nonverbal movement exchange?
  5. Describe the type of base of support that is established between the adult and the child, from which the child receives pleasure, understanding and comfort when exploring the surroundings and when returning to the adult in times of perceived danger or discomfort. Describe how these behaviors are portrayed in both the adult and the child through their movement qualities and movement exchange.

Reviewing the vignette with these questions in mind, it becomes clear that the easy turn-taking rhythmic exchange typically observed between mother and baby is not present between Ellie and Aaron. The timing of their unspoken dialogue is filled with pauses, and sudden and accelerated actions that are not contingent or attuned to each other. As the scene develops, their emotional connection becomes more strained, observable in Ellie’s increasing body tension, Aaron’s erratic stop and start movement phrasing, and their lack of joint eye contact. When Ellie places Aaron on her lap this disconnection is accentuated in the lack of molding in their body-tobody contact. Ellie’s body actions do not appear to provide a safe base of support for Aaron. Instead he is left balancing on her lap squinting his eyes and arching his back as she holds him firmly.

Key principles and related questions for parent–child interactions

Based on these questions dyadic movement activities are created to support the parent-child relationship. Through this practice the parents are taught to learn about their children’s movement styles and rhythms as well as their own tendencies. The dance therapist helps the parent discover similarities and differences in the qualities of their personal movement signatures, not expecting to find exact matches of style but rather compatibility between their unique styles. Finding compatibility alleviates blame and helps parents examine and understand the underlying meanings behind their reactions to their child’s behaviors. Parents learn which aspects of their nonverbal exchange best support their relationship and which aspects of their nonverbal style they may need to modify. An understanding of compatibility encourages parents to respect their children’s behaviors as a form of communication and not to perceive these behaviors automatically as deviant actions. Through this process parents recognize that most often a child’s behavior is a communication—even if it is a difficult one. Ways of Seeing has created several worksheets to help parents examine their nonverbal exchange with their child. A sample of the types of questions asked include:

Questions for parents: (Tortora, 2006 p 340 – 350)

  1. What meaning do you “read” in your child’s body expressions and what message is your child “reading” in your nonverbal behaviors?
  2. Spend some time watching your child. How does your child show his or her emotions—whether happy, sad, angry, tired, or frustrated? What body signals are used?
  3. What are your physical and emotional reactions to these body expressions and signals?
  4. What might a child be saying by how he or she is moving? Mirror the movement by trying it on. What does it feel like to you? What is your reaction?
  5. Most crucially, do you attune to your child’s style as reflected in the child’s cues, giving room for his or her expression before intervening? Or, do you respond from an internal impulse to help without attending to your child’s style first?

As Ellie and I view the video and discuss theses questions, she reveals that she is worried that if she softens her body her baby will consume her. Her strong tall posturing belies a deeper fear of victimization. On a very basic embodied level Ellie does not have the experience of being responded to in an attuned manner. She experiences Aaron’s nonverbal actions as demands on her. She does not mold her body into him to sooth him for she is concerned this will make him weak and unable to sooth himself.

Movement activities that support parentinfant attachment and communication

The parent’s responses to these questions are used to design nonverbal, dance and movement activities to support the development of the relationship. Activities are created for each dyad based on their own interactive movement styles. The themes of these activities include the following concepts:

  • Establishing eye contact: The focus here is to help the parents understand the qualities of the dyadic nonverbal dialogue emphasizing the ebb and flow that naturally occurs during engagement. The parents learn how to attune to the waxing and waning of the baby’s attention. These activities include playing with visual contact as well as spatial distances, dancing/ moving toward and away from each other in the surrounding space while staying emotionally engaged. I have created the term embraced space (Tortora, 2010a) to describe the emotional connection created between the intimate dyad that is maintained through the changing spatial distances of meaningful interactive exchange.
  • Trust: This principal focuses on establishing trust through body contact with an awareness that physical contact is a form of communication. Parents become aware of the quality of their and their child’s touch and holding style. Activities emphasize how body-tobody contact is established through yielding and molding or holding one’s body separate from other. Activities include qualities of hugging, swaying, and swinging to melodic and rhythmic music as a baby feels her body weight being moved and supported through a dancing exchange. Activities also include waiting for the baby to initiative engagement by closely watching her movement actions. In these activities the parent provides room for the baby to move on her own observing the baby’s motor curiosity
  • Internal regulation of body & moods: Feeling internally regulated on a body-felt level supports interaction. Relaxation methods are taught to help the parent with self-regulation, how to sooth her baby, as well as what multisensory conditions help her baby self-sooth. Parents become aware of the quality of their voice, the use of touch including different massage strokes, where they hold body tension, how the tension in their body reflects their mood, and how they express their reactions to their baby’s mood and nonverbal actions through their personal movement responses. Parents learn how to identify their own and their baby’s regulatory capacity as they dance to music along the spectrum from slow, medium, fast to super- fast. These different tempos are related to feelings and sensations of being calm and centered at on end to extreme distress and dysregulation at the extreme end. Parents also explore their own regulatory and deregulatory styles. Focus is placed on the circular connection between the mind, body and emotions. By playing with these concepts through creative dance, body awareness, methods of touch and holding, breath and relaxation activities parents learn to better monitor and gain control over their own regulatory behaviors while exploring the connection between their thoughts, feelings and nonverbal behaviors.
  • Self-discovery: The focus of these activities is to help the parents support the baby’s experience of how her movement actions have agency in the surroundings. These discoveries include increasing the baby’s awareness of her physical body- self by exploring simple actions such as reaching, grasping, pulling, pushing and climbing. How the child’s nonverbal behaviors affect a parent’s nonverbal reactions is also addressed. Parents are encouraged to follow their child’s lead through dance, movement, music and playbased games that support the baby to explore using props such as musical rhythms, musical instruments, scarves and streamers. Toddlers participate in creating pathways across the room using cushioned climbing equipment, circles pads and rug squares to climb, swing on, crawl through, rock on, and balance.
  • Object permanence: Games such as peek-a-boo, hide-n-seek, follow-theleader and stop-n-go are explored through movement and dance activities that travel through the room. Parents and babies find ways to stay connected, maintaining their embraced space from all different places in the room. Creative dance props including scarves, musical instruments and a variety of musical rhythms are used to facilitate these explorations that establish the parent – child relationship.
  • Relating: Following along the lines of the object permanence and self-discovery themes these dance activities include follow-the-leader by mirroring the leader’s exact actions and the feeling tone of the actions as well and responding with complimentary actions. Finger play musical games performed in synchrony or in response to the partner; and attuning, mismatched attunement, and re-attuning through movement explorations are created as the dyad dances and plays together. During these activities the parents pay attention to their child’s unique qualitative movement style incorporating these nonverbal qualities into their movement responses.
  • Independence: During these movement and dance activities parents learn to identify specific cues of their child that reveal self- exploration and initiation. Games of coming and going, crawling/ running toward and away from the parent, when the child is seeking connection verses exploration; and different ways to connect through eye contact, vocal cuing, body proximity, and gestural actions are explored.
  • Support movement and motor development: A great emphasis is placed on learning how touch is a form of communication. Touch is emotionally expressive. It can communicate love and kindness or aggression and disturbance. It can calm and co-regulate or excite and agitate the recipient of the touch. Parents learn how to use touch to guide their baby’s movement explorations rather then doing the action for the child by simply placing the baby in new positions. This enables the baby to experience how her own physical initiations and exertions influence her actions and her surroundings supporting her sense of agency, further developing an embodied sense of self.

The Ways of Seeing program offers these activities in a variety of contexts to best meet the needs of the families. These include parent-child groups, parenting groups, private parent –child dyadic sessions and sessions with the parent individually.

In Ellie’s private sessions we discover that during her extended moments of stillness she takes a quick shallow inhale and then holds her breath for extended periods of time. We realize that this physical behavior occurs even as we speak about the stresses in her life. Its prevalence in her movement repertoire is significant. We designate it as a movement metaphor and stay open to learning more about its origins. Exploring her breath holding pattern leads to an early memory of her hiding in a corner holding her breath and whole body in an extremely tense manner in an effort to not be heard or seen when her alcoholic abusive father entered the house. In this position she witnessed such a cacophony of chaos that during her retelling she unintentionally embodies this posture.

Two complimentary therapeutic activities are developed to repair this embodied pattern. First Ellie must be able to establish a sense of bodily safety so she can feel a sense of control rather then being flooded by these memories. We do this by teaching her how to maintain an equal length in her inhale and exhale particularly giving time to completely release her breath at the end of her exhale. We practice doing this as we continue to speak about her fearful history and her current stresses. She begins to make connections between feeling emotionally overwhelmed, her increased body tension, and fearful thoughts that often suddenly invade her.

This discovery delineates the specific mind – body- emotional continuum that drives her embodied behaviors. Ellie makes the association that the sporadic flinging leg and arm actions and increased vocalizations of Aaron act as a trigger setting off her negative response toward him. She becomes skilled at redirecting her attention away from this fearful reaction and body freeze. Instead, Ellie attends to the immediate moment, by taking full breaths until she feels quiet and calmer. She learns how to identify this calm sensation both emotionally and on a body level. I instruct her to take a “sensory photograph” (Tortora, 2006, p. 78) of this sensation, so she can bring it into her bodily conscious awareness whenever she is feeling overwhelmed.

Along with this breath activity personal expressive dances that further support body awareness and provide an additional way to explore these memories are created. Together we develop a body warm- up coordinating the flow of her breath with full body stretches lifting her arms up, to her sides and down. This evolves into large arm swings in all directions. As Ellie swings her arms around her lower torso she starts to extend the palms of her hands out into space at the end of the swing. In my kinesthetic seeing reaction it feels as if Ellie is pressing something away. We begin to enlarge this action and take it into space. A rhythmic dance is composed as she steps forward, sweeping her arms around and away, culminating with this pressing action. We move together at times in synchrony side-by-side, at times in nonverbal dialogue silently passing the imaginary object between us. Without speaking a word we share this experience. In my role as witness I am struck by an image of mobilizing forward while pushing away imaginary obstacles. During the verbal processing period after our embodied dyadic experience, Ellie confirms my kinesthetic images. She discussed how empowering it was to realize she did not have to remain frozen in time and space when she was overwhelmed. She could mobilize, pushing past this stuck sensation and reach for help when she was fearful.

As Ellie explores these new ways of being in her own body, she is able to experience Aaron’s nonverbal behaviors differently as well. The evolving dance games focus on rhythm, timing, space and touch. These qualities are explored through verbal play and full body dances. A vocal pas de deux emerges as Ellie and Aaron create a rhythmic dialogue by playing with the length of their pauses between each of their utterances. They take turns initiating the game as Ellie learns to stay emotionally present and physically engaged by approaching Aaron with eye contact and a softer body attitude. Smiles and giggles spontaneously arise lengthening their engagement and adding to the fun.

Aaron’s stop and start kicking rhythm is developed into playful contact. When Aaron kicks his leg into the air Ellie follows his path and taps each foot with a lighthearted expression. An alternating rhythmic game is created as Aaron excitedly varies the timing of his kick. This naturally evolves into a peek-a-boo game, when Ellie leans over and catches his feet using them to momentarily cover and then uncover her eyes and exclaims “peek-aboo!” as their eyes meet.

Ellie learns how to hold Aaron by shaping her arms and body around him as they dance to the beautiful undulating flow of waltz music. She releases her tension and breathes fully into her torso creating a secure firm container for Aaron. The waltz turns into a dance of dips and turns, as Ellie responses to Aaron’s enthusiastic reactions to the music by swaying his body to and fro. Ellie starts to enjoy Aaron and understands that the motivation behind his actions is to be with her rather then displaying signs of weakness. Aaron begins to thrive through these playful dance play interactions, becoming more animated and regulated. Ellie frozen pauses disappear as her nonverbal behaviors become more contingently related to the ebb and flow of Aaron’s behaviors.


The creative explorations in the Ways of Seeing program emphasize the communicative nature of each person’s unique nonverbal expressions. Dance, movement and play activities enable the parent and child to attune to the specific qualitative aspect of their nonverbal movement style. Through the personal therapeutic discussion and dance movement psychotherapeutically- based activities the parent learns how to better read her baby’s nonverbal cues. The baby’s embodied experience during these more positively co-regulated interactions supports his/her developing selfconcepts . Dialoguing through movement expression creates a resonance between self and other. A sense of self-efficacy and knowingness of other is experienced through these nonverbal exchanges. These activities encourage and strength the attachment relationship. The musicality of the emerging parent – infant relationship is realized on a felt-sense level through the dancing dialogue and emotionally through the improved relationship.

Individual and group sessions enable parents to explore their nonverbal movement repertoire to learn about their personal mind- body- emotional connections. This is very powerful for parents often discover that they did not experience attuned nonverbal interactions in their own childhood. Through body awareness, movement and dance explorations they embody attuned interaction. They also learn how to better regulate their own emotional responses through both calming and activating activities. They explore relaxation activities that focus on breath and body awareness and participate in group and individual expressive dance sequences created through their responses to music and emerging imagery that personally related to their life experiences.

In the composite case vignette, the quality of Aaron’s nonverbal actions initially triggered Ellie’s own difficult history. By exploring her associations to these actions along a mind- body- emotion continuum Ellie was able to disconnect these reactions from her baby’s behaviors. Aaron’s sense of body and self-agency develop as his repertoire of nonverbal experiences with his mother repair and expand through 8 THE SIGNAL JULY – SEPTEMBER 2011 their dancing dialogue. Their embodied shared experiences during these explorations enhance the intersubjective experience.

In our current era of increasing media and electronic stimulation, group day care, and sedentary activities, babies and toddlers need to explore their moving selves as a communicating source of connection within the context of meaningful relationships now more then ever.


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The Creative Embodied Experience: The role of the body and the arts in infant mental health


Tortora, Suzi,
United States,

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